Laneisha S Waller, PH.D.

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

Practice address

616 E Bloomington St
Iowa City, IA 52245-2600

Phone

(319) 337-6998

Fax

(319) 354-1679

NPI assigned

May 24, 2021

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Counseling and Health Center LLP

  • Mental Health Counselor
  • Iowa City, IA
  • NPI 1437120573
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1621814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716854400000",
    "number": "1386219186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "616 E BLOOMINGTON ST",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522452600",
            "telephone_number": "319-337-6998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "616 E BLOOMINGTON ST",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522452600",
            "telephone_number": "319-337-6998",
            "fax_number": "319-354-1679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLER",
        "first_name": "LANEISHA",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-24",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anne Marie Wallace, MA, CCC/SLP
• Jessica Lynne Wallace, NNP-BC
• Nakkia Wallace, RN
• Peter Dart Wallace, M.D.
• Robert B Wallace, MD
• Mary Kathryn Walling, PHD
• Anthony Walls, RN
• Ashley E Walls
• Brooke Marie Walls, PA-C
• Michael Wallum

• Counseling Psychologist in Iowa City, IA
• Providers in Iowa City, IA by specialty
• Counseling Psychologist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.